One of the most surprising additions to the daily morning routine since my heart attack has been the fistful of pills that I now take every day.

It can be a confusing mix of medications, each for a different purpose, and each with different benefits and side effects. Here’s just a sampling of some of the more common cardiac meds that doctors prescribe for heart patients.

Anti-platelet Agents

This type of heart medicine can help prevent clots from forming in blood vessels. It accomplishes this by preventing sticky blood platelets from clumping together. Your doctor may prescribe anti-platelet medication if:

you have had a heart attack

you have had a coronary stent implanted in a coronary artery

you have unstable angina

you have had strokes, including TIAs (transient ischemic attacks)

you have other types of heart disease

your doctor has noted plaque buildup in your blood vessels

you are at high risk for heart attack or stroke

Examples of anti-platelet medicine include aspirin, clopidogrel (Plavix), ticlopidine (Ticlid), ticagrelor (Brilinta – also known as Brilique and Possia in Europe), or prasugrel (Effient or Efient). Since side effects include increased bruising and bleeding, some people may not be able to take anti-platelet meds if they are at risk for bleeding.

Angiotensin-Converting Enzyme (ACE) Inhibitors

This type of heart disease medicine can help because they:

lower your blood pressure

make the heart’s work easier

help the heart work more efficiently

ACE inhibitors work by preventing your body from making angiotensin II, a hormone that makes blood vessels tighten, to help your blood vessels remain relaxed. Blood flows more easily through the vessels, lowering your overall blood pressure. Your heart doesn’t have to work so hard to pump blood through your vessels. About 20% of patients who receive ACE inhibitors develop a dry cough, a side effect so debilitating that you may need to stop the drug; it’s particularly common in women and those of black or Asian ethnicity. Talk to your physician if this side effect occurs. Capoten (captopril) and Vasotec (enalapril) are examples of ACE inhibitors.

Calcium Channel Blockers (CCBs)

This type of heart disease medicine is also called a calcium antagonist. CCBs can:

lower your blood pressure

reduce chest pain (angina)

help lower your heart rate

CCBs prevent calcium from entering the muscle cells in your heart and blood vessels, keeping blood vessels from tightening and causing the heart to pump with less strength. Your heart rate slows and blood can flow more easily through the vessels, lowering your blood pressure. Cardizem CD (diltiazem) and Norvasc (amlodipine) are examples of CCBs.

Beta Blockers

This type of medicine diminishes the effects of adrenaline and other stress hormones. They slow heart rate and reduce blood pressure, and are commonly used for treating:

abnormal heart rhythm

high blood pressure

heart failure

angina (chest pain)

acute aortic dissection

hypertrophic obstructive cardiomyopathy

anxiety

prevention of migraines.

Beta blockers also have been found to prevent further heart attacks and death after a heart attack. Other uses include the treatment of hyperthyroidism, akathisia (restlessness or inability to sit still), and anxiety. Some beta blockers are also used for reducing pressure in the eye caused by glaucoma.

Cholesterol-Lowering Drugs

Cholesterol-lowering drugs may help those already at high risk for heart disease in these ways:

lower LDL (bad) cholesterol levels

raise HDL (good) cholesterol

lower triglycerides (a fat in your blood)

Cholesterol-lowering drugs work in a variety of ways to improve your heart health. Some change the way the liver processes cholesterol and fat. Others affect the way your body digests nutrients, or prevent cholesterol from flowing through your blood vessels.

Vasodilators

Vasodilator heart disease medicine has two effects:

lowers your blood pressure

eases chest pain (angina)

Vasodilators relax the muscles in your blood vessel walls. The vessels widen and blood flows through more easily, lowering blood pressure and providing more blood and oxygen to the heart so it doesn’t have to work so hard to pump. These drugs are often prescribed PRN – meaning take whenever you need them. They also widen all blood vessels in your body, not just around your heart, including those to the brain, which can cause severe headaches for many patients. Try taking a Tylenol™ about 20 minutes before taking any vasodilator to avoid getting the famous ‘nitro headache‘.

9 Responses to “What you need to know about your heart medications”

I do take all the meds. I am thinking of reducing some of them. I don’t feel they are doing anything for me, in fact they are making me very anxious. I’m very tired, I have very little energy. I was OK when I first came out of hospital but now the drugs have got into my system, not so sure they are right.

Hello Celia – I’m not a doctor so of course cannot comment on your medications. Pease see your doctor right away. Right now, you just don’t know if it’s your meds that are causing you to feel tired or anxious, or if it’s a completely different medical issue that might need attention. Ask your doctor for a “Medication Review” to see if any of the meds you’re taking might be having a bad interaction with one of your other drugs. But do not stop taking any of your meds before discussing this decision with your doctor!

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Alice in NZ -
October 30, 2009

Thank you for this list and clear description. Everybody should know exactly what meds we’re taking and their precise purpose. For years, I’ve just been blindly filling my prescriptions and taking my heart pills without really thinking about them – I just trust that my doctors are right. But after reading some of the informative postings on your other website Ethical Nag, I am now motivated to double and triple-check every drug I put into my body. We cannot afford to be passive helpless patients anymore. How do we know that the drug we’re happily taking today won’t be tomorrow’s deadly “Vioxx”? THANK YOU.

♥ For women living with heart disease, from the unique perspective of CAROLYN THOMAS, a Mayo Clinic-trained women's health advocate, heart attack survivor, blogger, author, speaker here on the west coast of Canada

♥ Information for the general public, heart patients or their family members, health professionals, and all students of the heart

the presentations

♥ Learn more about my recent and upcoming presentations – including my annual HEART SMART WOMEN presentationin Victoria, BC Canada on Tuesday, February 26th! Free admission, open to all, but pre-registration is required (this class is always full with a waiting list). ♥

the news

♥ The first WomenHeart Support Group program in Canada is being held at Royal Jubilee Hospital in Victoria, BC on the third Wednesday evening of each month. Any woman living with heart disease is invited to attend. For more info, email Rose at: rlopetrone (at) shaw (dot) ca

♥Free Virtual Support Groups offered by WomenHeart: The National Coalition for Women With Heart Disease, scheduled throughout each month on three specific topics: Heart Failure, Atrial Fibrillation or General Heart Disease in Women. Check the current schedule to sign up.